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| Print out this form, fill out and return to Deborah Kaplan 701 Oxford Road, Bala Cynwyd, PA 19004-2111 Fax (610) 667-2859 * Phone(610) 667-5889 A check for $247 should be mailed to Deborah with this order Please call with any questions Sold to: _________________________________ Phone: _________________________________ Fax: _________________________________ Ship to: _________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ Name of Ketubah:_______________________________ Text: Egalitarian ____ Traditional ___ Conservative ___ All English ___ (Great Circle only) Bride English Name: _________________________________ Hebrew Name: _________________________________ English Transliteration: _________________________________ Bride's Mother English Name: _________________________________ Hebrew Name: _________________________________ English Transliteration: _________________________________ Bride's Father English Name: _________________________________ Hebrew Name: _________________________________ English Transliteration: _________________________________ Groom English Name: _________________________________ Hebrew Name: _________________________________ English Transliteration: _________________________________ Groom's Mother English Name: _________________________________ Hebrew Name: _________________________________ English Transliteration: _________________________________ Groom's Father English Name: _________________________________ Hebrew Name: _________________________________ English Transliteration: _________________________________ Wedding Date: _________________ After Sunset? __________ Place of wedding: City: ___________________ State: ____________ Person to call with questions: ____________________________ Phone: _________________________________ Fax: _________________________________ The rest of this form is for Traditional or Conservative Texts only Check if Bride's father is a Levite ___ Cohain ___ Check if Groom's father is a Levite ___ Cohain ___ Bride is Single ___ Divorced ___ Widow ___ Convert ___ Is Bride's father alive? _____ |
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